Résumé
Tobacco use is widely prevalent in substance using patients in treatment settings. Nearly three times as many individuals with alcohol and drug problems smoke cigarettes compared to the general population. In addition to addressing the primary drug of abuse, it is important to systematically assess characteristics and patterns of tobacco use and treat tobacco dependence in these patients as they are at high risk of mortality from tobacco related illnesses..Consecutive patients presenting to the Tobacco Cessation Clinic of a national level deaddiction centre were assessed in detail using a semi-structured proforma. Most were males(97.3%) and majority (61.8%) of patients belonged to the 21-40 yrs age group. Most were self employed and primary drug of abuse was heroin in 47 (42.3%) and alcohol in 44 (39.6%) subjects. 53 (47.7%)used smoking tobacco only, 16 (14.7%) used only smokeless tobacco and 40 (36%) used a combination of both. Majority of smokable tobacco use was in the form of bidi (69.4%). Majority of the subjects (56.7%) were in the contemplation stage of change whereas 36 (32.7%) of subjects had taken steps towards quitting the use of tobacco products and qualified for the action stage as per RTCQ. The majority of patients qualified for moderate [56 (50.9%) dependence] to high dependence [37 (33.3%)] as per FTND score. This has obvious treatment implications.